Cervical Cancer Diagnosis

Cervical
cancer was once the leading cause of cancer death for
women in the United States. It's much less common today, mainly because of the
availability of the Pap test and the human papillomavirus (HPV) vaccine.

According
to the Centers for Disease
Control and Prevention (CDC), the Pap test can find cervical cancer early, when it’s
most treatable. It can also alert doctors to changes in the cervix that occur
before any cancer develops. Additionally, the HPV vaccine can prevent infection with the virus,
which is the cause of nearly all forms of cervical cancer.

The
American Cancer Society (ACS) estimates that
there are over 12,000 new cases of cervical cancer every year and over 4,000
deaths from it. This is why the ACS recommends that all women ages 21
to 65 get Pap tests, either every three years or, combined with an HPV test, every
five years.

Making Sense of Test Results

During a Pap test,
a sample of cells is taken from the cervix and the cervical canal. The sample
is tested and will be either negative or positive. Negative results mean that
no cell abnormalities were detected. Positive results mean that abnormal cells
were seen in the sample. Positive results can be confusing. They are explained
below.

Squamous Intraepithelial Lesion (SIL)

The word squamous means “plate-like” or
“scaly” and refers to squamous cells. These are the relatively flat cells that
make up the outer layers of the cervix. According to the ACS, SIL is further
categorized as either low grade or high grade.

Low-grade SIL (LSIL)
indicates mild changes to the cells (dysplasia) that might resolve without
treatment but could lead to more ominous precancerous changes. High-grade SIL (HSIL) indicates
changes that are likely to become cancerous without treatment. High-grade
lesions are determined to represent moderate dysplasia, severe dysplasia, or
carcinoma in situ (CIS or noninvasive cancer).

These designations
are part of the Bethesda system of classification and are used to describe
abnormal Pap test results.

Dysplasia and Cervical Intraepithelial Neoplasia (CIN)

Intraepithelial neoplasiarefers
to the new formation of a lesion within the cervical tissue. According to the ACS, the lesion, or
tumor, will be labeled as follows:

CIN
1 for
mild dysplasia

CIN
2 for
moderate dysplasia

CIN
3 for
severe dysplasia or CIS

It’s important to
note that CIN is not cancer. It only designates the presence of abnormal cells.
If discovered early enough, it can be treated.

Cancer Staging

If your doctor
determines that you do have cervical cancer, the next step will be to determine
whether the cancer has spread. This process is known as staging. Physicians use
one of two classification systems. The first is the FIGO system. The other, which is more
common in the United States, is the American Joint Committee on Cancer’s TNM system.

The TNM system
assigns a stage from 0 to 4 to indicate the general state of the cancer, and
adds additional letters and numbers to indicate specific features of the tumor.
Number-letter combinations with the letter T indicate the extent of the tumor. Number-letter
combinations with the letter N indicate if the cancer has spread to nearby
lymph nodes. Number letter combinations with the letter M indicate if the
cancer has spread (metastasized) to any distant parts of the body.